Dental
Elite Smile Center, LLC
Elite Smile Center, LLC was paid $182K by Medicaid between Jan 2018 and Oct 2024, across 14 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 22% of everything it billed.
33Billing provider infoELITE SMILE CENTER, LLC
KAILUA KONA, HI 96740
KAILUA KONA, HI 96740
33aNPI1104162858assigned 12/28/2012
33bProvider typeGeneral Practice Dentistry
28Total paid$182K
24GClaims4,938
24DCodes billed14
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in Hawaii
Rank by total paid#17 of 63
Median peer was paid$33K
This provider vs. median5.5×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,946 | $48K | |
| 2019 | 1,676 | $38K | |
| 2020 | 357 | $10K | |
| 2023 | 437 | $36K | |
| 2024incomplete | 522 | $48K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 22% | 258 | 160 | $40K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 757 | 757 | $25K |
| D9310 | 12% | 333 | 333 | $23K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 598 | 598 | $22K |
| D0330 | Panoramic radiographic image | 11% | 278 | 278 | $20K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.1% | 937 | 691 | $11K |
| D0272 | Bitewings - two radiographic images | 5.2% | 365 | 365 | $9K |
| D1208 | Topical application of fluoride, excluding varnish | 4.1% | 705 | 705 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 3.9% | 438 | 433 | $7K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.3% | 95 | 40 | $6K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.9% | 67 | 62 | $3K |
| D1110 | Prophylaxis - adult | 1.2% | 44 | 44 | $2K |
2 more codes
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCHAEKAL, WON (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Big Island Smiles Orthodontocs LLC | Kailua Kona, HI | $426K |
| Dental World Kaneohe LLC | Kaneohe, HI | $37K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.